Tuesday, October 11, 2005

"It could kill a billion people worldwide, make ghost towns out of parts of major cities, and there is not enough medicine to fight it," ABC News reports. It is the avian flu, and if it were to reach U.S. shores, the nation's top health experts say it "would make the scenes of Katrina pale in comparison." According to Shelley Hearne, director of the nonprofit Trust for America's Health, it "would be like having a Category 5 viral hurricane hit every single state simultaneously." Moreover, say U.S. and United Nations health experts, it is no longer a question of whether the avian flu pandemic will hit, but when, and how severely. "On behalf of the [World Health Organization], I can tell you that there will be" such an outbreak, Health and Human Services (HHS) Secretary Michael Leavitt said last week. "The only question is the virulence and rapidity of transmission from human to human." Unfortunately, notwithstanding the potential catastrophic impact of such a pandemic, nor the high likelihood of its spread, the Bush administration has left Americans dangerously unprepared for a deadly outbreak.

A DANGEROUS NEW STRAIN: Sixty-five people have been killed by the avian flu thus far. All were infected directly by birds, scientists say, though "every infected person represents one step closer to the tipping point," when the disease can be spread efficiently from human to human. "Right now in human beings, it kills 55 percent of the people it infects," says Laurie Garrett, a senior fellow on global health policy at the Council on Foreign Relations. "That makes it the most lethal flu we know of that has ever been on planet Earth affecting human beings." Each year, Garrett says, "different flus come, but your immune system says, 'Ah, I've seen that guy before. No problem. Crank out some antibodies, and I might not feel great for a couple of days, but I'll recover.'" Yet the current constellation has apparently never been seen in our species, so "absolutely nobody watching this has any natural immunity to this form of flu." Alarmingly, scientists announced on Thursday that the last massive flu pandemic in 1918 was "also a bird flu that jumped directly to humans." That strain of "Spanish flu" killed 50 million people worldwide.

KATRINA FAILURES DWARFED BY LACK OF PANDEMIC FLU PREPARATION: Last week, the New York Times published details of the Bush administration's draft plan to deal with a domestic pandemic flu outbreak. It shows "that the United States is woefully unprepared for what could become the worst disaster in the nation's history." The plan details how a large outbreak originating in Asia would likely reach U.S. shores within "a few months or even weeks," and that if such an outbreak occurred, "hospitals would become overwhelmed, riots would engulf vaccination clinics, and even power and food would be in short supply." The draft's "conservative estimate" predicts as many as 200,000 Americans will die within a few months, and that a vaccine will not be available until half a year after the first outbreak, and then only in limited supply. "I imagine that not a lot of poor people will get vaccinated," Laurie Garrett of the Council on Foreign Relations says. "If you think about New Orleans, this is a similar situation."

YET AGAIN, BUSH HAS LET U.S. FALL BEHIND REST OF WORLD: There is currently no vaccine to prevent the spread of avian flu, though there is one medicine to treat it. "Called Tamiflu, it is made by the Roche pharmaceutical company in Switzerland," and is now under huge demand. According to Secretary Leavitt, the objective is to stockpile 20 million doses of Tamiflu, though health experts believe the United States should optimally have enough doses for at least half the population, approximately 150 million people. Only 2 million are currently on hand. And though Leavitt claims that "no other country is in a better position," officials in Australia have 3.5 million doses, while Great Britain will soon have enough to cover a quarter of their population. The medicine is being made available on a first-come, first-served waiting list, and the United States is "nowhere near the top." When asked why the United States did not place its orders for Tamiflu sooner, Leavitt replied, "I can't answer that. I don't know the answer to that." Even Senate Majority Leader Bill Frist (R-TN) says the current Tamiflu stockpile could spell disaster. "That's totally inadequate. Totally inadequate today."

I may as well jump on this bandwagon, since I just got my (non-avian) flu shot this morning.

Well, *if* (and it's likely) this virus does make a pandemic leap to humans, it will be about as devastating on a global scale as the tsunami was in Southeast Asia.

Why?

Avian flus are usually far more devastating once they've made the leap over, as mammals (including humans) have not built up tolerances to the various mutations these viruses undergo.

The Council on Foreign Relations devoted its most recent issue of the prestigious journal, Foreign Affairs, to what it called the coming global epidemic, a pandemic.

"Each year different flus come, but your immune system says, 'Ah, I've seen that guy before. No problem. Crank out some antibodies, and I might not feel great for a couple of days, but I'll recover,'" Garrett says. "Now what's scaring us is that this constellation of H number 5 and N number 1, to our knowledge, has never in history been in our species. So absolutely nobody watching this has any natural immunity to this form of flu."

Or, to quote Robert Webster of St. Jude's Children's Hospital, "'This virus right from scratch is probably the worst influenza virus, in terms of being highly pathogenic, that I've ever seen or worked with,' Webster says. Not only is it frighteningly lethal to chickens, which can die within hours of exposure, swollen and hemorrhaging, but it kills mammals from lab mice to tigers with similar efficiency. Here and there people have come down with it too, catching it from infected poultry. Half the known cases have died."

How does it make the leap from birds to humans?

Believe it or not: pigs. Pigs can carry both the type A virus (most avian flus) and type B virus (mammalian). Once the two strains meet, they can actually exchange DNA with each other (yes, this is called "sex").

And of course, in Southeast Asia, pigs and birds mingle with a frequency that would alarm any antimiscegenist!

So what's America's first line of defense? Is it as bad as former FEMA director, Michael Brown?

Uh huh.

POINT MAN FOR PANDEMIC FLU FEARED TO BE ANOTHER MICHAEL BROWN: If the avian flu does reach the United States, the HHS official overseeing the response will be Stewart Simonson, Michael Leavitt's assistant secretary for public health emergency preparedness. Simonson's resume is "disturbingly reminiscent" of that of disgraced former FEMA chief Michael Brown. Though Simonson is "now the point man for just about every health emergency that may hit our shores, ranging from anthrax attacks to an avian flu pandemic," he has no background in medicine, public health, or bioterrorism preparedness. His chief accomplishment seems to be his position from 1995-1999 as legal counsel to former Wisconsin Gov. Tommy Thompson, who was tapped as President Bush's first Health and Human Services secretary. (Simonson reportedly specialized in "crime and prison policy" under Thompson.) A fact sheet released by Rep. Henry Waxman (D-CA) notes that at a House Government Reform hearing on July 14, 2005, Simonson "claimed he had sufficient funds to purchase influenza vaccine and antiviral medication for the nation. The next day, his office submitted a funding request to Congress seeking an additional $150 million for flu vaccine and antiviral medication."

"Liberals got women the right to vote. Liberals got African-Americans the right to vote. Liberals created Social Security and lifted millions of elderly people out of poverty. Liberals ended segregation. Liberals passed the Civil Rights Act, the Voting Rights Act. Liberals created Medicare. Liberals passed the Clean Air Act, the Clean Water Act. What did Conservatives do? They opposed them on every one of those things...every one! So when you try to hurl that label at my feet, 'Liberal,' as if it were something to be ashamed of, something dirty, something to run away from, it won't work, Senator, because I will pick up that label and I will wear it as a badge of honor." -- Matt Santos, The West Wing